Anxiety: A Few Tools for Your Toolbox

I feel frustrated about anxiety. Why? Because I see people suffering from it a lot, and yet there are many things we can do to alleviate and manage our anxiety. Below I’ve described some basics on how to do so, using techniques from Cognitive Behaviour Therapy and Acceptance and Commitment Therapy.

What is anxiety?

Anxiety has been referred to as our fight or flight system; or, in more technical terms, our sympathetic nervous system. Anxiety is the physical and psychological symptoms based on a perceived threat. I like to think of it as an alarm system that tells us when there’s a threat. This system is there to keep us safe, but sometimes it is too sensitive and it goes off when it doesn’t need to. Like an overprotective grandma, it has good intentions but might stop of us from doing things that are relatively harmless.

People often find the physical symptoms that come along with anxiety uncomfortable or even distressing. At a physiological level, anxiety is a high state of arousal that results from a surge of adrenaline. It primes our body for action, primes our body to defend itself and increases our performance and stamina. Physical symptoms often include shaking, sweating, muscle tension, fast heartbeat and fast breathing. Overbreathing, or hyperventilation, which means breathing a volume of air greater than which we require, can result in additional physical symptoms, including chest discomfort, numbness or tingling in the hands and feet, dizziness, and faintness.

Why do we have anxiety?

Given our experience of anxiety is probably mostly negative, it’s hard to remember why we might have anxiety in the first place. Anxiety is likely a protective mechanism that has evolved to prevent us from entering into potentially dangerous situations and enable us to escape from them. In fact, to a certain extent, anxiety can be good for performance. According to Yerkes-Dodson law, there’s an optimal ratio of anxiety and performance - We need some anxiety to perform our best, but too much anxiety can hinder our performance. A confident and experienced musician, for example, might perform her best in front of a live audience; whereas someone performing for the first time might have difficulty concentrating and focusing due to anxiety.

Our anxiety alarm system is sometimes too sensitive

It’s important to note that there are different levels of anxiety, and sometimes the level of threat doesn’t warrant the level of anxiety. Sometimes our anxiety alarm system is going off when it doesn’t need to. Overprotective grandma! For example, if we were hiking in the woods and came across an aggressive grizzly bear, our anxiety system might start going off in full force and we might be having thoughts like, “I’m going to die.” This is an appropriate thought – your odds aren’t great if you come across an aggressive grizzly bear. Alternatively, if you’re doing a presentation in front of classmates and you’re extremely anxious, you might also have thoughts like, “I’m going to die” and your anxiety alarm system is blaring. This is an example of when it's being overprotective. Of course it’s normal to have some anxiety when we’re doing a presentation - people are watching us and most of us fear being judged by others, but we’re not going to die.

Why does our anxiety alarm system go off when it doesn’t need to?

When our anxiety alarm system is going off when it doesn’t need to, it’s usually because we are excessively focusing on the worst-case scenario, or catastrophizing. That is, overestimating the probability of something bad happening and underestimating our ability to cope with a difficult situation, or assuming that people are noticing and judging us more than they actually are. This excessive focus on the negative will tell our anxiety alarm system that there’s a serious threat in our midst, and before we know it the alarm is going off.

Types of anxiety

As you probably already know, not everyone experiences anxiety in the same way or about the same situations. A helpful way to explore and understand the different types of anxiety is to break them down into thoughts, emotions, physical sensations, and behaviours. As you can see from the graph below, each part of the system influences the other, which also means we can intervene at any part to change the whole system.

Some common types of anxiety include anxiety for specific situations (e.g., anxiety when writing exams), generalized anxiety (excessive worrying about a range of things and difficulty controlling our worry), and social anxiety (anxiety that occurs in social situations when there’s a significant fear of being judged). Below I’ve described these different types of anxiety based on their associated thoughts, emotions, physical sensations, and behaviours.

Know your thoughts

The first step in treating anxiety is to really understand the thoughts that are fueling your anxiety. This may sound easy, but our thoughts often happen automatically, outside our awareness, and we usually assume they are true without really noticing or considering them. In getting to know your thoughts, try to be your own detective and explore your thoughts with curiosity.

Here are some tips:

When you notice a negative emotion, ask yourself, what am I thinking right now? Take a few deep breaths.

Describe your thought (e.g., “I’m having a thought that I’m a failure.”).

Let go of judgment. Be kind and curious. When we judge ourselves for having certain thoughts, we add another layer of negative emotion. For example, we may think, “I’m so weak for thinking this way”, and then not only do we feel anxious, but we feel ashamed. Also, by adding this extra layer of negative emotion, we might not fully recognize what the initial thoughts and feelings were, and therefore we won’t be as effective in alleviating the initial anxiety (Linehan, 2014).

Challenge your thoughts

Once we've identified a negative or unhelpful thought, it's important to challenge it to see if it can be replaced with a more helpful, balanced thought. As I mentioned earlier, our anxiety is sometimes like an overprotective grandma. In other words, when we’re anxious, we may be excessively focusing on the worst-case scenario, or catastrophizing. Specifically, we’re likely overestimating the probability of something bad happening, underestimating our ability to cope with a difficult situation, or assuming that people are noticing and judging us more than they actually are. Challenging our thoughts allows us to replace these more extreme thoughts with a more balanced way of thinking, thereby decreasing negative feelings such as anxiety.

Here’s an example of an anxiety-inducing situation that most of us can probably relate to. Sam is talking to his friend Meg in the cafeteria. While they’re talking, Meg keeps looking over Sam’s shoulder at the clock on the wall. Sam thinks, “Meg thinks I’m boring” and begins feeling anxious and a bit sad. He is also experiencing tightness in his chest, and his stomach starts to hurt.

Here are some guidelines on how to challenge your thoughts, some questions you might ask yourself to come up with more balanced thoughts:

Thinking Traps: Am I falling into a thinking trap? Am I catastrophizing (thinking worst-case scenario)? Am I 100% sure that this will happen? Is this a small hassle or a life-altering problem?

Check the facts: What evidence do I have that this is true? What evidence do I have that this is maybe not true? Have I confused a thought with a fact? Is my judgment based on the way I feel instead of facts?

Alternative Explanations: Is there another way of thinking about this situation?

Role Reversal: What would I tell a friend if they had this thought? What would a friend tell me about this thought?

Ability to Cope: Could I cope with or handle the “bad” outcome?

Advantages and Disadvantages: Is it helpful to think this way? Even if it’s true, is it helpful to focus on this? Maybe it’s more helpful to try to find solutions for the issue, or to focus on the positive.

For more tips on challenging your thoughts and coming up with more balanced thoughts, refer to this handout on realistic thinking.

By considering these alternative thoughts, Sam will hopefully be able to make room for a more balanced and helpful way of thinking about the situation with Meg, and therefore feel less anxious.

Try thought defusion

There are times when it might be difficult to challenge the unhelpful thought that is fueling your anxiety. For example, maybe the thought is true, or it’s stubborn and sticks around even after you challenge it, or simply it feels true. A technique called thought defusion, from Acceptance and Commitment Therapy (Hayes, Strosahl, & Wilson, 1999), can help us with thoughts that we tend to get “hooked” on. With thought defusion, you will learn how to mindfully observe your thoughts without getting stuck on them. Also, with practice, it gives you the freedom to choose which thoughts you want to focus on and which thoughts you want to let go of. Thought defusion requires imagining and visualizing your thoughts as objects outside of yourself going by, as pictures or words harmlessly floating away without you analyzing them or obsessing about them.

Here are some common thought defusion visualizations:

Imagine sitting in a field watching your thoughts float away on clouds.

Picture yourself on a mountain, looking down at a stream, and your thoughts as leaves on that stream floating by.

See your thoughts written in the sand and then watch the waves wash them away.

Imagine yourself sitting under a tree, watching your thoughts float down on leaves.

Now try this exercise: Think about a time when you recently felt anxious (e.g., during an exam or presentation, during a conflict with a loved one, when meeting someone for the first time, while speaking up in a meeting at work, while riding in an airplane, etc.). Focus on that thought, and pick one of the visualizations above to help you get some distance from the thought.

Remember, the point of thought defusion is to get some psychological space from your thoughts, so you can see them a bit more objectively, less as truths, and then be able to choose with a clear mind whether or not you want to focus on them. This short video explains the concept of thought defusion with some fun and simple illustrations:

Some tools for your toolbox…

It is important to note that these tools aren’t quick fixes, but with practice and perseverance, they can help you manage and alleviate your anxiety so that you’re not held back in your life by a well-intentioned but sometimes excessively protective anxiety alarm system. If you are experiencing a high level of anxiety, it is highly recommended you seek out professional help (check out our Resource Section). I have also listed some self-help resources below that many of my clients have found helpful.